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4 


THE  LIBRARY 

OF 

THE  UNIVERSITY 

OF  CALIFORNIA 

LOS  ANGELES 


. 


i^'^^'^mm'^mmmmmmmmmmmmfm^mmmmmmmm^  --rTrrTrrrrw»w.»-,ir« 


L)ENT18'1^K^' 


I J>  E  N  'r  A  L    E  D  U  ( 1  AT  1 0  N 


FAST,  PKliSHNT  AND  FUTHKH, 


AS   l{KI,A'n<;i)  ■!'(»   MKDICINI] 


W.     W  .     A  L  Ll'O  R1\     M.I).,    I).  D.S., 


Kl*;ri!IN'l'KI>   FKdIM    TIIK  (MIICAUO    M  K1U(!.\  I,  .lOIMtNAI,   AND    KXAIMINKI! 
Koii   Ai'itll,,    I  SSI. 


ClIK'AiiO: 
'I'lCKKlJ,   NKWHM.  iV  CO.,  I'HI  N'I'KKS. 

ISSI. 


At  the  late  banquet  of  the  Alumni  Association  of  Rush  Medi- 
cal College,  it  was  expected  that  Dr.  Allport  would  respond  to 
the  sentiment,  "  Dentistry  and  Dental  Education,  its  Past, 
Present  and  Future  as  related  to  Medicine."  The  speakers  on 
this  occasion  were  however  restricted  in  time  to  five  minutes,  and 
thus  he  was  only  able  to  give  a  brief  synopsis  of  what  he  had  in- 
tended to  say,  reserving  his  address  in  full  for  the  transactions  of  the 
Association.  We  however  anticipate  this  publication  by  present- 
ing his  address  to  our  readers,  in  the  present  issue  of  the  Jour- 
nal AND  Examiner.  That  those  who  practice  in  the  depart- 
ment of  dentistry  known  as  dental  surgery,  or  the  treatment  of 
the  natural  teeth  and  their  surroundings,  should  be  medically 
educated  and  therefore  regarded  as  special  practitioners  in  medi- 
cine, can  hardly  be  questioned.  But  that  dental  practitioners 
not  medically  educated  should  be  admitted  as  medical  practition- 
ers, is  scarcely  debatable.  The  only  door  to  the  medical  profes- 
sion is  through  regularly  constituted  medical  colleges  ;  and  we 
would  suggest  to  our  dental  friends  that  the  means  for  acquiring 
the  highest  scientific  knowledge  of  their  calling,  should  be  found 
in  these  institutions.  But  it  should  be  remembered  that  a  full 
medical  education  has  not  been  required  or  demanded  of  those 
about  entering  upon  dental  practice. 

The  suggestion  that  medical  graduates  should  be  better  in- 
formed regarding  this  subject  is  worthy  of  consideration,  and  we 
do  not  see  how  the  position  taken  by  the  doctor  can  be  well  con- 
troverted, for  it  is  a  fact,  as  said  by  the  physician  to  whom  he 
refers,  that  medical  men  "  do  not  know  much  about  the  teeth." 
When  a  full  medical  education  is  demanded  of  those  entering 
upon  the  practice  of  dental  and  oral  surgery  (and  the  sooner 
it  is  demanded  the  better)  we  have  no  doubt  that  medical  colleges 
will  prepare  themselves  to  meet  the  demand,  and  instruct  not 
only  as  to  the  diseases  incident  to  that  portion  of  the  body  and 
the  science  of  their  treatment,  but  provide  such  clinical  teaching 
as  will  best  qualify  the  student  to  put  his  knowledge  into  practice. 


The  suggestion  made  that  medically  educated  men  who  practice 
dental  and  oral  surgery  should  be  received  in  the  American 
Medical  Association  on  an  equal  footing  with  the  practitioners  in 
any  other  department  of  medicine  and  have  assigned  to  them  a 
section  on  dental  and  oral  surgery,  claims  attention.  When  the 
demand  is  made  we  do  not  see  why  it  should  not  meet  with  a 
respojse.  This  ;!epartment  of  practice  should  advanc.  so  as  to 
stand  among  the  important  specialties  of  medicine. — Editorial 
from  the  Chicago  Medical  Journal  and  Examiner,  April,  1881. 


RESPONSE   TO   THE   TOAST, 

DENTISTRY  AND  DENTAL  EDUCATION 

ITS  PAST,  PRESENT  AND  FUTURE,  AS  RELATED 
TO  MEDICINE. 


I  hardly  know  how  to  respond  to  the  sentiment  just  read. 
"  Dentistry  and  Dental  Education — its  Past,  Present  and  Fu- 
ture, as  related  to  medicine,"  contains,  as  the  lawyers  would 
say,  several  "distinct  counts,"  either  of  which  gives  rise  to  more 
thought  than  can  well  be  expressed  in  the  time  it  would  be  proper 
for  me  to  occupy  on  the  present  occasion.  Contrary  to  the  pop- 
ular notion,  dentistry  is  not  entirely  of  modern  origin.  Its  his- 
tory dates  far  back  into  the  centuries. 

To  respond   fully,   therefore,  to   the   sentiment   proposed,    I 
should  be  obliged  to  trace  carefully  and  consecutively  ttyhis-^  CJ 
try,  both   ancient  and  modern,  and  assume  to  be  a  prophet  and 
foretell  its  future. 

With  facts  at  hand  and  time  to  do  it,  it  is  not  a  difficult  task 
to  write  history  ;  but  it  is  always  a  risky  business  to  venture 
upon  prophecy. 

As  we  are  far  more  interested  in  the  present  and  future  of 
dentistry  than  in  the  far-off  past,  I  shall  be  pardoned,  I  trust, 
Mr.  President,  if  I  but  briefly  allude  to  its  early  history,  and 
confine  what  I  may  say  to  more  modern  times  ;  and  instead  of 
predicting  the  future  of  dentistry,  I  will  state  what  I  think  it 
ought  to  be,  trusting  that  what  should  be  will  be. 

Of  the  early  history  of  dentistry  we  know  but  little.  That  it 
was  practiced  at  a  very  early  period  is  fully  proven  by  the  facts 
that  teeth  well-preserved  from  gold  fillings  have  been  found  in 
the  mouths  of  mummies,  and  also  that  artificial  teeth,  mounted 


upon  gold  plates  have  been  discovered  in  the  monuments  of  the 
Egyptians. 

We  are  told  that  the  ancients  practiced  it  as  a  specialty  in 
medicine.  But  if  so,  its  practice — like  that  of  surgery — seems 
to  have  fallen  into  the  hands  of  mechanics  at  a  later  period. 

During  the  latter  part  of  what  is  known  as  the  middle  ages  in 
Europe,  surgery,  as  you  are  aware,  was  practiced  by  barbers,  by 
the  advice  and  under  the  direction  of  physicians  ;  and  it  will 
hardly  do  to  suppose  that  at  this  time  dentistry  was  of  higher 
rank  than  surgery. 

Soon  after  this,  or  cotemporary  with  the  period  mentioned  by 
medical  writers  as  the  revival  of  surgery,  the  first  steps  were 
taken  toward  modern  dental  surgery  ;  and  associated  with  the 
dental  literature  of  those  times  stand  the  names  of  Eustachius, 
Fallopius  and  Pare,  known  to  have  been  among  the  first,  if  they 
were  not  the  very  first,  surgeons  and  writers  of  their  times.  In  fact, 
it  is  owing  to  these  great  men  of  that  day  that  surgery,  whether 
general  or  special,  was  first  placed  upon  a  scientific  and  reliable 
foundation  of  dissection.  Later,  other  medical  men  wrote  more 
or  less  upon  the  anatomy,  diseases  and  treatment  of  the  teeth. 
Prominent  among  these  was  John  Hunter,  up  to  whose  time 
England  or  the  world  had  not  produced  so  great  a  surgeon.  I 
mention  these  things  to  remind  you  that  the  writings  upon  the 
teeth  up  to  about  the  last  of  the  eighteenth  and  first  of  the  nine- 
teenth centuries  were  by  anatomists  and  surgeons,  and,  1  will 
add,  that  they  treated  more  of  the  structure,  functions  and  dis- 
eases of  the  teeth  than  in  giving  any  practical  direction  as  to 
their  treatment  when  diseased. 

As  the  structure  and  functions  of  the  teeth  became  better  un- 
derstood, and  their  importance  to  a  healthy  condition  of  the 
body  more  fully  realized,  medical  men  began  to  appreciate  the 
importance  of  their  preservation.  But  class  influence,  which  has 
always  ruled  so  strongly  in  European  countries,  and  placed  the 
ban  of  social  ostracism  upon  all  who  engage  in  hand  labor,  may 
be  assigned  as  one  reason  why  practical  dentistry  did  not  receive 
its  first  great  impulse  from  those  who  did  so  much  to  enlighten 
the  medical  profession  as  to  the  structure  of  the  teeth  and  their 
diseases. 


Dental  operations  at  that  time,  whatever  they  may  have  been 
— like  the  Tude  surgery  of  a  century  or  two  before — seem  to 
have  been  practiced  as  an  art ;  the  latter  by  barbers,  and  the 
former  by  jewelers  and  smiths.  Dentistry  in  those  days  con- 
sisted very  largely  of  making  artificial  teeth. 

During  the  latter  part  of  the  eighteenth  century,  the  art  began 
to  be  practiced  in  America.  As  it  proved  to  be  remunerative 
for  the  services  rendered,  and  as  muscle  and  brain  enter  into  a 
more  equal  contest  for  respectability  in  America  than  in  Europe, 
our  country  became  the  most  fruitful  field  for  the  development  of 
practical  dental  science.  Americans,  always  quick  of  percep- 
tion, soon  discovered  that  diseases  of  the  teeth  could  not  be  in- 
telligently and  successfully  treated  without  a  knowledge  of  their 
anatomical  structure,  as  well  as  of  their  surroundings  ;  and,  like 
the  barber-surgeons  of  whom  I  have  spoken,  they  began  to  study 
anatomy.  Some  even  ventured  so  far  upon  the  domain  of  medi- 
cine as  to  acquire  a  limited  knowledge  of  physiology  and  pathol- 
ogy, and,  with  the  purchase  of  a  few  secret  prescriptions,  they 
assumed  to  be  and  the  people  dubbed  them  as  "  doctors."  As  the 
need  for  a  more  scientific  education  became  apparent,  medical 
men  began  to  engage  in  the  practice  of  dentistry,  both  as  oper- 
ators upon  the  natm'al  teeth  and  as  makers  of  artificial  teeth. 
From  this  point,  especially  in  our  own  country,  the  science  and 
practice  of  dentistry  rapidly  developed.  Dental  magazines  and 
text-books  were  published,  dental  associations  and  colleges  were 
established,  and  soon  the  superior  skill  of  American  dentists 
became  so  generally  acknowledged  that  their  services  were  in 
demand  in  nearly  all  the  countries  of  Europe. 

When  dental  colleges  were  first  established,  dentistry  consisted 
mainly  in  the  cleaning  and  extraction  of  the  natural  teeth,  in 
the  treatment  of  inflamed  or  diseased  gums  and  in  filling  what 
would  now  be  regarded  as  the  simpler  forms  of  cavities  ;  also  in 
mounting  artificial  teeth  upon  gold  and  silver  plates,  in  the  set- 
ting of  pivot  teeth  and  in  regulating  the  simpler  cases  of  mal- 
arranged  teeth.  At  that  period,  extraction  was  the  approved 
treatment  for  teeth  with  exposed  or  aching  pulps,  abscess  of  roots 
or  absorbed  sockets.  Now,  not  only  teeth  with  exposed  but  dead 
pulps,  abscess  of  roots,  atrophied  surroundings  and  necrosed  jawS 


are  regularly  and  successfully  treated  and  saved.  In  no  corre- 
sponding period  of  time  have  the  improvements  in  surgery  been 
so  great  as  during  the  present  century,  and  in  no  department  of 
conservative  surgery  have  they  been  so  emphasized  as  in  the 
treatment  of  diseases  of  the  teeth  and  mouth  ;  and  to  my  calling 
must  the  credit  of  this  improvement  be  mainly  given.  Noiv  to 
adopt  extraction  as  the  rule  of  practice  in  such  cases  would  be 
considered  mal-practice. 

Artificial  teeth  are  now  mounted  not  only  upon  gold  and  sil- 
ver plates  but  upon  at  least  ten  diflFerent  bases,  of  various  degrees 
of  applicability  and  usefulness  in  the  cases  requiring  substitutes 
— each  requiring  an  entirely  different  manipulation  and  mode  of 
treatment.  In  order  to  bestow  the  greatest  benefits  of  the  art,  a 
thorough  knowledge  of  making  and  applying  these  various  kinds 
of  work  is  absolutely  essential. 

In  addition  to  the  great  improvements  in  the  setting  of  artifi- 
cial teeth,  as  a  branch  of  mechanical  dentistry,  artificial  fixtures 
are  now  so  constructed  as  to  be  far  more  generally  useful  in  the 
treatment  of  cleft  palate  than  is  the  surgeon's  knife.  These  im- 
provements are  but  indications  of  the  advance  in  all  directions  in 
practice. 

In  the  earlier  days  of  our  dental  schools,  so  little  was  em- 
braced within  the  practice  of  dentistry  that  a  two-years'  course 
of  college  instruction  seemed  sufficient  to  qualify  students  to 
practice  in  the  two  departments  at  the  standard  then  main- 
tained. But  with  the  improvements  and  expansion  thus  far 
made,  it  is  no  longer  possible.  There  is  enough  now  em- 
braced in  either  department  to  engage  the  entire  time  and 
talent  of  any  one  individual,  and  the  greatest  excellence  can 
only  be  secured  by  a  division  of  practice.  Those  whose  tastes 
and  talents  best  fit  them  for  mechanical  dentistry  should  pursue 
that  as  a  branch  of  art,  and  give  it  their  exclusive  attention  ;  and 
those  who  practice  dental  and  oral  surgery  should  pursue  it  as  a 
branch  of  medicine,  and  educate  themselves  accordingly.  To 
this  division  of  practice  the  objection  is  urged  that  the  two  de- 
partments "  lock  and  inter-lock  "  so  intimately  that  the  separa- 
tion is  not  practicable.  No  doubt  patients  would  find  it  more  con- 
venient to  receive  the   mechanical   and   medical   treatment  from 


the  same  person.  So,  too,  it  would  be  more  convenient  for  the 
afflicted  to  have  their  limbs  amputated  and  artificial  ones  sup- 
plied by  the  same  practitioner ;  or  to  have  the  otologist  treat  the 
ear  and  furnish  ear-trumpets  of  his  own  manufacture.  But  ex- 
perience has  proven  that  patients  are  best  served  by  receiving 
medical  treatment  from  medical  men,  and  manufactured  articles 
from  mechanical  artists. 

The  same  principle  holds  good,  and  must  hold  good,  in  the 
two  departments  of  dentistry. 

An  accomplished  mechanical  dentist  must  now  not  only  under- 
stand the  nature  and  manner  of  manipulating  the  various  mate- 
rials I  have  mentioned  into  plates  for  artificial  teeth,  but  he  must 
be  so  skilled  as  a  mechanic  that  he  will  be  able  to  adapt  these 
materials  to  the  requirements  of  the  case  in  hand  in  such  a  way 
that  patients  will  derive  the  greatest  benefit  possible  from  artifi- 
cial teeth  as  masticators.  He  should  be  so  versed  in  art  that  he 
can  adapt  them  to  the  face  of  the  patient — in  size,  shape,  color 
and  position  in  the  mouth — so  perfectly  as  to  conceal  the  fact 
that  they  are  not  natural ;  and  so  fully  should  he  understand  the 
essentials  to  correct  and  easy  enunciation  that  they  will  act 
as  aids  instead  of  impediments  to  speech,  as  is  now  too  frequently 
the  case. 

The  apprenticeship  to  an  ordinary  trade  is  not  less  than  three 
years,  and  it  can  hardly  be  claimed  that  less  time  should  be  de- 
voted to  acquiring  this  most  difficult  art  than  is  spent  in  learning 
to  be  a  blacksmith  or  a  carpenter.  Whoever  pursues  the  calling 
properly  will  have  no  time  for  the  practice  of  medicine  in  any  of 
its  branches. 

About  the  same  degree  of  anatomical  knowledge  should  be  re- 
quired of  the  mechanical  dentist  that  is  expected  of  the  painter, 
sculptor  or  maker  of  artificial  limbs,  and  more  than  this  is 
scarcely  necessary. 

I  have  now,  as  concisely  as  possible,  given  you  a  general  idea 
of  the  history  and  present  status  of  dentistry  ;  and  I  wish  to  say, 
in  as  emphatic  a  manner  as  I  can,  that  it  is  to  our  dental  colleges, 
and  to  the  arduous  and  self-denying  labors  of  the  teachers  in  those 
schools,  more  than  to  any  other  cause,  that  dentistry  owes  its 
present  honorable  position    in    the   community  and   itts   standing 


8 

among  the  sciences.  Each  succeeding  year  the  teachings  in  our 
dental  colleges  are  becoming  more  scientific,  reaching  farther 
into  the  realm  of  medicine  ;  and  still  they  claim  to  cover  but  a 
portion  of  the  science  in  their  teaching.  In  proportion  as  stu- 
dents are  inclined  to  the  study  of  medicine  are  they  disinclined 
to  practice  in  mechanical  dentistry.  Not  only  is  it  becoming 
distasteful  to  this  class  of  practitioners,  but  they  are  dissatisfied 
with  confining  their  operations  exclusive!}' to  the^ teeth.  Grad- 
ually but  surely  are  the  best  medically  educated  dentists  reach- 
ing for  and  bringing  within  the  scope  of  their  practice  all  opera- 
tions and  treatment  not  only  of  the  teeth  but  of  the  jaws  and 
oral  cavity,  and  owing  to  their  great  familiarity  with  the  dis- 
eases of  the  mouth  and  their  habitual  use  of  the  delicate  instru- 
ments required,  it  is  fitting  that  medically-educated  specialists  in 
dental  and  oral  surgery  should  control  this  department  of  prac- 
tice. The  ease  and  accuracy  they  acquire  in  operating  about 
these  parts  could  not  be  possessed  by  the  general'  sU-rgeon. 

Any  treatment  for  arresting  disease  is  legitimately  a  branch 
of  medicine,  no  matter  whether  it  be  pills,  powders,  the  sur- 
geon's knife,  the  cautery  or  materials  for  filling  teeth.  All  are 
equally  therapeutical  agents.  But  their  intelligent  use  must  be 
based  upon  a  knowledge  of  anatomy,  physiology,  pathology, 
chemistry  and  therapeutics;  for  the  human •  organism  is  so  inti- 
mately related  that  each  part,  either  directly^  or  indirectly, 
affects  every  other  part.  The  same  hearts  blood  sends  its  arte- 
rial currents  to  every  point ;  the  same  nerve  centers  radiate  their 
impressions  throughout  the  system,  and  the  same  vital  force  per- 
vades every  atom  of  its  structure.  This  specialism,  therefore, 
cannot  be  legitimate  unless  its  practice  is  laid  in  the  fundamental 
principles  of  medicine. 

Appreciating  this  fact,  there  is  a  growing  tendency  among  the 
best  dental  graduates  to  make  the  diseases  of  the  teeth  and 
mouth  a  specialty  in  medical  practice;  and  that-  they  may  be  better 
qualified  to  do  this,  many  of  them  supplement  their  dental  edu- 
cation with  a  full  course  of  instruction  at  our  medical  colleges. 

Much  of  this  time  could  be  saved  if  these  colleges  provided 
ample   instruction   in   dental  and   oral  surgery,  and  exacted  of 


their  graduates  a  knowledge  of  the  pathology  of  the  diseases  \n 
this  specialty  and  the  science  of  their  treatment. 

Dental  text-books  devoted  to  diseases  and  treatment  of  the 
teeth  are  seldom  found  in  medical  libraries,  and  medical  text- 
books, as  well  as  lectures  in  medical  colleges,  have  hitherto  been 
comparatively  silent  upon  this  subject ;  which  fact  has  necessi- 
tated the  organization  and  maintainance  of  dental  colleges — 
until  it  is  claimed  by  some  that  dentistry  has  almost  created  for 
itself  a  separate  science.  But  since  the  teeth  constitute  a  por- 
tion of  the  human  body,  there  can  be  no  separate  science  for 
the  treatment  of  their  disease. 

All  change  from  rest  to  unrest  in  any  organ  of  the  body  is  a 
change  from  health  to  disease,  and  its  pathology  and  treatment 
should  be  taught  in  medical  text-books  and  colleges.  Without 
it  they  are  but  partial  teachers  of  the  curative  art,  and  fall, 
therefore,  short  of  accomplishing  their  whole  mission.  As  med- 
ical colleges  are  now  constituted,  medical  graduates  go  forth  in 
as  great  or  greater  ignorance  of  diseases  of  the  teeth  than  do 
dental  graduates  of  general  disease.  As  an  illustration  of  this 
lack  of  knowledge  on  the  part  of  physicians,  1  will  give  a  single 
instance,  which  is  a  fair  sample  of  others  constantly  occurring, 
and  which  could  be  given  by  almost  any  dental  practitioner. 

A  physician  of  large  and  respectable  practice  came  to  me  a 
few  months  ago  with  a  patient  having  a  swollen  face.  Said  he, 
"  Doctor,  this  patient  has  been  suffering  for  several  days  with 
toothache,  and  as  nothing  I  can  do  affords  relief  I  have  brought 
her  to  you  to  have  the  nerve  killed."     I  replied : 

"  Yes,  Doctor,  I  see  it  is  an  ulcerated  tooth.  The  nerve  has 
undoubtedly  been  dead  for  a  long  time." 

On  raising  the  upper  lip,  I  called  his  attention  to  an  abscess 
just  ready  to  burst,  over  the  root  of  a  cuspid  tooth.  I  took  my 
bistoury  and,  with  a  slight  puncture,  brought  the  pus.  Said  he, 
"  Doctor,  are  you  sure  the  nerve  in  that  tooth  is  dead  ?  "  I  re- 
plied that  an  abscess  over  the  root  of  a  tooth  was  one  of  the 
surest  indications  of  the  death  of  the  pulp,  and  passed  an  instru- 
ment the  entire  length  of  the  nerve  canal,  to  convince  him  that 
the  pulp  was  dead,     He  looked  thoughtful  for  a  moment,  and 


10 

said,  "  I  don't  think  physicians  know  much  about  diseases  of  the 
teeth."  I  told  him  I  thought  lie  was  nearer  right  in  that  re- 
mark than  in  his  diagnosis  of  this  case. 

Now,  this  physician  was  not  only  a  professor  in  a  medical  col- 
lege but  he  was  the  occupaat  of  a  chair,  which  made  it  reason- 
able to  suppose  that  he  would  know  the  diiference  between  pulp- 
itis and  alveolar  abscess.  Had  he  but  listened  to  a  few  lectures 
on  dental  pathology,  in  his  student  days,  he  would  hardly  have 
made  this  humiliating  mistake. 

Medical  colleges  do  not  educate  specialists ;  they  but  lay  the 
foundation  for  general  practice.  This  knowledge  acquired,  the 
practitioner  may  turn  his  attention  to  general  practice  or  the 
specialty  of  his  choice ;  and  by  the  application  of  the  principles 
first  taught,  he  is  supposed  to  become  more  than  ordinarily 
skilled  in  the  treatment  of  the  particular  class  of  diseases  in  his 
specialty. 

With  this  idea  in  view,  there  is  no  more  reason  why  we  should 
have  colleges  for  the  teaching  of  the  science  involved  in  dental 
or  oral  surgery,  independently  of  general  medicine,  than  for  gen- 
eral surgery. 

One  of  the  first  requisites  to  success  in  the  practice  of  any  de- 
partment of  surgery  or  dentistry,  is  mechanical  and  executive 
talent.  Without  these  a  physician  may  be  able  to  diagnosticate 
accurately  and  prescribe  scientifically,  but  he  can  never  succeed 
as  an  operator,  either  in  dental  or  general  surgery.  But  if  he  is 
educated  in  either  of  these  specialties,  without  a  general  medical 
education,  he  is  left  no  choice  save  to  follow  that  branch  for 
which  he  is  educated,  though  he  finds  by  experience  that  he  has 
not  the  requisite  talent  to  succeed  in  its  practice.  Many  gradu- 
ates of  our  dental  colleges  find  themselves  in  this  ver}''  unpleas- 
ant position.  The  result  is,  we  have  too  many  engaged  in  dental 
practice  Avho,  neither  by  taste  nor  talent,  are  fitted  for  it ;  and, 
lacking  a  medical  education,  they  cannot  engage  in  general  prac- 
tice. Properly  educated,  many  of  them  would  make  excellent 
practitioners  in  medicine,  but  they  are  failures  as  dentists,  as 
they  would  have  been  as  surgeons. 

The  change  advocated  would  give  the  student  a  chance  for 
the  exercise   of    his    choice,   ennabling    him,   after    his    regular 


11 

college  course,  to  select  the  special  branch  for  which  he  feels 
himself  to  be  best  adapted.  If  he  chooses  the  specialty  of  dental 
and  oral  surgery,  rather  than  to  engage  in  the  general  practice 
of  medicine,  the  teaching  he  has  received  should  be  supple- 
mented by  such  clinical  and  other  instruction  as  will  best  qualify 
him  to  engage  in  that  department  of  practice.  A  medical  edu- 
cation should  embrace  a  general  knowledge  of  all  diseases  to 
which  the  human  organism  is  liable,  and  their  treatment.  Spe- 
cialism includes  this  knowledge,  to  which  is  added  careful  and 
special  study  of  the  diseases  and  treatment  that  come  within  a 
given  department  of  practice.  A  dental  education,  therefore,  is 
a  medical  education,  plus  dental — or,  special  knowledge  of  the 
diseases  and  treatment  of  the  teeth  and  oral  cavity. 

I  therefore  advocate  the  teaching  in  our  medical  colleges  of  the 
science  of  dental  and  oral  surgery,  not  only  that  dental  students 
may  gain  a  broader  medical  education,  but  that  medical  students 
may  be  better  informed  regarding  the  diseases  and  treatment  of 
the  teeth.  The  signature  of  the  professor  or  professors  of  dental 
and  oral  surgery  should  be  considered  as  important  upon  the  di- 
ploma of  graduation  as  the  signatures  of  the  teachers  in  any 
other  department. 

At  no  previous  time  in  the  history  of  medicine  in  our  country 
has  the  necessity  for  a  fuller  course  of  medical  instruction  be- 
come so  apparent  as  the  present ;  and  it  will  not  be  long  before 
a  three-years  course  will  be  requisite  to  the  respectable  standing 
of  any  medical  college  with  the  profession.  In  making  this 
change  the  fact  should  not  be  overlooked  that  their  course  can- 
not be  complete  without  the  teaching  of  the  diseases  and  treat- 
ment of  the  teeth  by  properly  educated  and  practical  dental  and 
oral  surgeons. 

With  this  broader  and  better  medical  education  on  the  part  of 
dental  and  oral  surgeons,  and  a  better  knowledge  of  the  nature 
and  influence  of  the  diseases  of  the  teeth  and  mouth,  and  their 
proper  treatment,  on  the  part  of  medical  men,  there  could  be  no 
valid  objection  to  the  establishment  of  a  section  in  dental  and 
oral  surgery  in  the  American  Medical  Association,  upon  an  equal 
footing  with  any  other  department  of  medical  science.  The  import- 
ance of  this  movement  is  being  discussed  among  the  most  advanced 


12 

dental  practitioners  and  the  most  comprehensive  medical  teach- 
ers. Sooner  or  later,  this  fuller  and  better  education  and  condi- 
tion must  come,  and  the  action  of  our  medical  colleges  will 
largely  determine  whether  its  consummation  will  be  hastened  or 
retarded ;  but,  though  delayed,  this  ultimate  result  will  obtain. 

As  America,  less  wedded  to  old  ideas  and  practices  than  Eu- 
rope, gave  to  practical  dentistry  its  first  great  impulse,  so,  too,  it 
may  not  be  impossible  that  in  this  great  Northwest,  where  ad- 
vanced ideas  more  rapidly  take  root  and  expand,  and  new  needs 
are  more  readily  met,  the  first  steps  may  be  taken  towards  this 
desired  end. 

Having  detained  you  longer  than  is  customary  on  such  occa- 
sions, with  my  thanks  for  your  kind  attention,  and  believing  that 
some  such  plan  as  I  have  suggested  for  dental  and  medical  in- 
struction would  be  beneficial  to  the  public,  as  well  as  those  en- 
gaged in  practice,  I  leave  these  thoughts  for  your  consideration. 
If,  perchance,  what  I  have  said  should  receive  a  greater  audience 
than  this  presence,  I  ask  for  it  considerate  thought  and  a  gener- 
ous criticism. 


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